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ELECTRICAL PERiVIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvrw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />/���� .S� � �%�� / �u��G�/�C G'L�i� -G�i`� %S�.�r..�'� <br />PROJECTADDRESS <br />.� p � <br />�-�,.,,ls, "S �'�l r�>' �L1Cz l FF-��'r�S`//r./�6✓�/ �,JcytJ`l- t✓,�i �',k',j' <br />O�enef �1ail Address City StatelLp Phone <br />y ,/ y�i ,/ /l <br />��, il�.?;7" �l�� ���✓�- .> f = �f%�l � "�/f���l �'f t�// ��'7F �,7� � _ <br />Tenanl Mail Address Ciry StatefLp Phone <br />i <br />�i r ����Ii�l�7i��y t��� G��k�„��. �d�,%� v�.•�tr'/f� i✓,�. ���:G� /�/7fJ�;�`�L <br />Eleclncal Contrador Mail Address Ciry State2ip Phone <br />J"CF�G'IQ��G�i,� tiL_ <br />tate License Number <br />� ( , <br />/�-f .�/�/G;;V�Ir�ii"iG� <br />Propased Use of B illding <br />� <br />�^ . �� <br />�r�.�� <br />Contract Pnce of Work <br />f , <br />7lt� �'o" �<ri�fi'�/•�"�> L�:;�G'llz!'i <br />Conlecl Person (Plan R view) <br />L � � <br />DescriptionofWarktoBeDone: �'�%���7=i"� �!�/�FIC�/i��/!i'%G•/;':: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhat ! have read and ezamined (his application and know the samo ta be Kue and <br />correct. All provisions ollaws ontl oNinances goveming this type o/woAc will be completed <br />whether specified herein or not. The granting ol a permd does not Fresume to give authonty to <br />violate or cancel (heWo visions o/any ofher state or local Imv regu/ahng conshuction or fhe <br />peAonnance ol construcfion. That 1 am auMionzed by (he owner olthis propeAy to perlo�m the <br />work lor which applicafion is made and 1 comply with the Sta(e Contractors Law 18.27 RCW antl <br />296200 WAC. <br />i ,' /% <br />I�'-" <br />/. <br />FEE <br />.-"`�-/ 3 <br />," <br />